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Internalising disorders are one of the most common mental health problems in children under 12 years, yet mixed findings exist for current treatment options. This pilot involves a novel 10-session intervention, BEST-Foundations, to treat internalising symptoms in children using a family-inclusive model. Initial findings and feasibility using a mixed-methods approach are reported. Twenty-two participants from eight families (n = 8 children; n = 8 mothers; n = 6 fathers) participated in an uncontrolled single treatment design. Included children (aged 3–11 years) reported clinical-level internalising symptoms on the Child Behaviour Checklist. Data were collected across four timepoints: baseline, pre-intervention, post-intervention, and 4-weeks follow-up. As predicted, mothers reported large improvements in child internalising symptoms pre-post (SMD = −.83; 95% CI = 50.58–70.42) and maintained pre to follow-up (SMD = −.92; 95% CI = 50.14–69.11). Sustained improvements were also found in externalising problems and total problems. Qualitative analysis indicated families reported positive improvements in targeted areas including parent confidence and parent–child relationships. Findings demonstrate initial feasibility data and effect size estimates comparable to previous trials using the "BEST" framework, and larger than CBT-based interventions. Results are considered preliminary due to the small sample. Further evaluation is warranted, showing the value of family-inclusive interventions to treat child internalising problems. What is already known about this topic: Modifiable family-based risk and protective factors influence internalising symptoms in children. Currently, inconclusive support exists for targeted treatment options for child internalising symptoms, highlighting the need to explore novel, feasible, evidence-based approaches for children under 12 years. Parental involvement in treatment is considerably heterogeneous, and the inclusion of fathers is lacking. What this topic adds: The BEST-Foundations intervention translates from theory to practice, demonstrating initial feasibility with families in improving internalising symptoms in children under 12 years. Fathers may express initial hesitation, yet engaging them in treatment is important. Parents reported improved confidence and perspective taking after taking part in the BEST-Foundations intervention. [ABSTRACT FROM AUTHOR]

IntroductionAthletes frequently experience anxiety and depression at rates similar to or higher than non-athletes. A balanced diet can alleviate athletes internalizing symptoms. Moreover, diet and sleep are all associated with internalising symptoms. Our study investigates how sleep quality mediates the impact of dietary habits on internalizing symptoms in athletes.MethodsThe current cross-sectional study involved 758 Chinese young athletes. The adapted Australian Athletes Diet Index was used to assess dietary patterns, and sleep was measured using the Athletes Sleep Screening Questionnaire. The Generalised Anxiety Disorder 7 scale and the Patient Health Questionnaire 9-item scale were used to assess symptoms of anxiety and depression. Structural Equation Modelling (SEM) analysis was used to examine the mediating role of sleep quality in young athletes. Raw scores of chronotypes, sleep quality, anxiety and depression were calculated for the statistical analysis.ResultsNo significant indirect effects were found in adolescents. In adult athletes, diet mediated the relationship between chronotype and sleep quality (β = −0.028, p

Summary: Maternal psychological control has been linked consistently to poorer adjustment for adolescents, however, studies of variability in the association between psychological control and adjustment are rare. Sleep serves crucial bioregulatory functions that promote well‐being and protect youths against poor adjustment associated with negative family environments. We hypothesised that the link between maternal psychological control and adolescent maladjustment would be strongest for youths with poorer actigraphy‐based sleep. The current study included 245 adolescents (Mage = 15.79 years, 52.2% girls, 33.1% Black/African American and 66.9% White/European American; 43% at or below the poverty line). Adolescents reported on their mothers' psychological control toward them, as well as their internalising and externalising symptoms (aggressive and rule breaking behaviours). Several sleep variables were derived: minutes, onset time, and variability in each parameter over 1 week. For youths with shorter, less consistent sleep (both mean levels and variability in minutes and onset), maternal psychological control was associated with adjustment difficulties, especially externalising symptoms. This association was not significant for youth obtaining longer, more consistent sleep. The results were most evident for variability in sleep minutes and onset as moderators of effects. The findings suggest that longer and more consistent sleep is an important protective factor in the context of more controlling parenting. [ABSTRACT FROM AUTHOR]

The strengths and difficulties questionnaire (SDQ) consist of five sub-scales that have been used to measure internalising and externalising symptoms in children, typically by combining sum scores of two sub-scales each, and pro-social behaviours. However, the different possible factorial structures that represent these symptoms have not been formally tested in a nationally representative sample of UK children. In addition, it is necessary to assess whether the SDQ is interpreted similarly across subgroups of the population. Exploratory and confirmatory factor analysis were used to test three competing structures for the parent-reported SDQ collected at age 11, the start of adolescence, in the UK Millennium Cohort Study (n = 11,519), and measurement invariance was assessed according to sex and a measure of deprivation of the area in which households lived. Internal consistency using ordinal alpha, internal convergent validity and external discriminant validity using average variance explained (AVE), and predictive validity were assessed. A five-factor model and a model with two second-order factors for internalising and externalising symptoms had better model fit than a three-factor model. For both structures, invariance was demonstrated across sex and area-level deprivation. AVE scores for the five-factor model indicated that peer and emotional problems factors were measuring a similar construct, as were the hyperactivity and conduct factors. In the second-order model, AVE scores indicated internalising and externalising symptoms were distinct constructs. A second-order model with two factors for internalising and externalising symptoms is appropriate for use in a cohort of UK children born in 2001/02, and our finding of invariance across sex and area-level deprivation indicate that the SDQ can be used in analysis investigating differences in symptoms across subgroups of the population. [ABSTRACT FROM AUTHOR]

This study examined whether avoidant coping behaviours and acculturative stress functioned as mechanisms linking perceived discrimination to internalising mental health symptoms among African immigrants living in the United States. We used cross‐sectional data collected between December 2019 and January 2020 from US‐based first and second‐generation African immigrants (N = 599, 50% first‐generation, 82% Black, 71% female, mean age = 30). Path modelling was performed to examine the mediating role of avoidant coping and acculturative stress on the relationship between perceived discrimination and internalising symptoms. Results showed that perceived discrimination was related to internalising symptoms via avoidant coping and acculturative stress (specifically social and environmental stress). These results provide support that coping strategies and acculturative stress are likely important micro‐level mechanisms by which the discrimination‐mental health association persists. Implications and recommendations for prevention and intervention to reduce negative impacts of perceived discrimination on immigrant mental health are discussed. [ABSTRACT FROM AUTHOR]

Abstract Background School-based universal social and emotional learning (SEL) interventions implemented during the transition to adolescence may be efficacious in preventing the development of mental health difficulties. This protocol describes a two-arm parallel cluster randomised controlled trial to investigate the impact of a universal SEL intervention (Passport, compared to usual provision) on internalising symptoms (primary outcome), emotion regulation, well-being, loneliness, social support, bullying, academic attainment, and health-related quality of life in English primary school pupils aged 9–11 years. A developer-led trial demonstrated the feasibility, acceptability, and utility of Passport; this will be the first independent trial. Methods Sixty primary schools will be recruited across the Greater Manchester city region and surrounding areas, involving 2400 pupils aged 8–9 at baseline. Schools will be allocated to the intervention arm to implement Passport over 18 weekly sessions or to the control arm to implement the usual school curriculum. Random allocation will be at school level following completion of baseline measures, with minimisation to ensure balance across trial arms in school size and free school meal eligibility. Measures will be collected at baseline, post-intervention (12 months post-baseline), and at 12 months follow-up (24 months post-baseline). The primary outcome analysis (intervention effects on internalising symptoms at post-intervention) will comprise a two-level (school, child) hierarchical linear model, following the intention-to-treat principle. Additional analyses will be undertaken to assess intervention effects on secondary outcomes, maintenance effects for all outcomes, intervention compliance moderator effects, subgroup moderator effects, and mechanisms underpinning intervention effects on the primary outcome. A mixed-methods implementation and process evaluation will examine factors that influence implementation, and a health economic evaluation will assess the cost-effectiveness of the intervention. Discussion Findings will provide educators with crucial knowledge of whether and how increasing emotion regulation through a universal intervention impacts internalising symptoms and a range of related outcomes. Findings will also inform policy related to the promotion of mental health among children and young people. If the intervention is found to be efficacious in reducing internalising symptoms and is also cost-effective, it may offer high potential as a preventative intervention for widespread implementation. Trial registration ISRCTN12875599; registered on 24 November 2022

Especially since the 2010s, we have seen rapidly increasing discussion and research on the causal and correlational relations between digital gaming and different dimensions of well-being. This quantitative study presents a starting point of a four-year longitudinal study of the connections between adolescents’ gaming motives, gaming culture participation, and different aspects of psychosocial well-being (digital engagement, internalising symptoms, and academic adjustment) in a sample (N = 2053) of actively gaming Finnish 6th and 8th graders (ages 11–14). Results show three distinct player profiles differing in gaming motives and well-being correlates: escapist game players, achiever game players, and recreational game players. These provide a starting point for exploring both the interactions between gaming and well-being and the stability of gaming motives over time.

Background: School-based universal social and emotional learning (SEL) interventions implemented during the transition to adolescence may be efficacious in preventing the development of mental health difficulties. This protocol describes a two-arm parallel cluster randomised controlled trial to investigate the impact of a universal SEL intervention (Passport, compared to usual provision) on internalising symptoms (primary outcome), emotion regulation, well-being, loneliness, social support, bullying, academic attainment, and health-related quality of life in English primary school pupils aged 9–11 years. A developer-led trial demonstrated the feasibility, acceptability, and utility of Passport; this will be the first independent trial. Methods: Sixty primary schools will be recruited across the Greater Manchester city region and surrounding areas, involving 2400 pupils aged 8–9 at baseline. Schools will be allocated to the intervention arm to implement Passport over 18 weekly sessions or to the control arm to implement the usual school curriculum. Random allocation will be at school level following completion of baseline measures, with minimisation to ensure balance across trial arms in school size and free school meal eligibility. Measures will be collected at baseline, post-intervention (12 months post-baseline), and at 12 months follow-up (24 months post-baseline). The primary outcome analysis (intervention effects on internalising symptoms at post-intervention) will comprise a two-level (school, child) hierarchical linear model, following the intention-to-treat principle. Additional analyses will be undertaken to assess intervention effects on secondary outcomes, maintenance effects for all outcomes, intervention compliance moderator effects, subgroup moderator effects, and mechanisms underpinning intervention effects on the primary outcome. A mixed-methods implementation and process evaluation will examine factors that influence implementation, and a health economic evaluation will assess the cost-effectiveness of the intervention. Discussion: Findings will provide educators with crucial knowledge of whether and how increasing emotion regulation through a universal intervention impacts internalising symptoms and a range of related outcomes. Findings will also inform policy related to the promotion of mental health among children and young people. If the intervention is found to be efficacious in reducing internalising symptoms and is also cost-effective, it may offer high potential as a preventative intervention for widespread implementation. Trial registration: ISRCTN12875599; registered on 24 November 2022 [ABSTRACT FROM AUTHOR]

Objective: No synthesis of the Australian evidence regarding targeted prevention and early intervention for mental health concerns among young children exists. This review aimed to (1) describe the types of targeted community-based mental health programmes evaluated in Australia to support children aged 1–9 years exhibiting internalising and/or externalising symptoms and (2) examine their impact on children's internalising and externalising symptoms and disorder diagnosis. Method: A systematic review and meta-analysis was conducted (PROSPERO: CRD42021255257). Four databases (PsycINFO, PsycArticles, MEDLINE and CINAHL) were searched for Australian studies published in the past 10 years that quantitatively evaluated the impact of a targeted programme on children's mental health. The National Institute of Health Quality Assessment Tools were used to evaluate the study quality. Results: Forty-two studies were included; the majority (67%) were medium quality. The mean sample size was 142 (SD = 170), children's average age was 5.78 years (SD = 2.44) and 58% were male. Aboriginal and Torres Strait Islander children were underrepresented. Studies evaluated 16 programmes that targeted (1) externalising symptoms (n = 20 studies, n = 6 programmes), (2) internalising symptoms (n = 14 studies, n = 7 programmes) or (3) both, termed transdiagnostic programmes (n = 8 studies, n = 3 programmes). Externalising programmes achieved a significant moderate mean reduction in externalising behaviours (standardised mean differences = −0.56), internalising programmes yielded a small mean improvement in anxiety symptoms (standardised mean differences = −0.25) and 57% reduced odds of anxiety disorder diagnosis. Evidence supporting transdiagnostic programmes was inconclusive. Conclusion: Parenting-focused programmes targeting young children's internalising or externalising behaviours have the largest local evidence base supporting their effectiveness. Limitations include a lack of engagement with fathers, triangulation of outcomes, homogeneity and implementation reporting. Greater implementation and evaluation of community-driven integrated and systemic approaches that identify, engage and support Australia's most disadvantaged cohorts of young children and their families are needed. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the association between social withdrawal motivations (peer isolation, shyness, unsociability, low mood, and avoidance) and symptoms of hikikomori using both variable- and person-oriented analyses. Method: Adolescents (N = 212) participated in this cross-sectional study. Data were collected using the Social Withdrawal Motivations Scale and the Avoidance subscale of the Child Social Preference Scale-Revised, the 25-item Hikikomori Questionnaire, the Personality Inventory for the DSM-5 Brief Form, and the Interpersonal sensitivity subscale of the Brief Symptom Inventory. Results: Path analysis revealed that peer isolation, shyness, unsociability, and avoidance were associated with symptoms of hikikomori while covarying for age, sex, maladaptive personality, and interpersonal sensitivity. Cluster analysis based on social withdrawal motivations identified four subtypes of adolescents. The group with high social withdrawal motivations showed the highest level of overall personality dysfunction and interpersonal sensitivity. Additionally, the group with high social withdrawal motivations and the group with high avoidance demonstrated higher symptoms of hikikomori compared to the other two groups, after accounting for the effects of the covariates. Conclusions: The findings highlight that the evaluation of co-occurrent social withdrawal motivations may improve the ability to identify those adolescents most in need of support. [ABSTRACT FROM AUTHOR]

Aims. Multiple studies have connected parenting styles to children's internalising and externalising mental health symptoms (MHS). However, it is not clear how different parenting styles are jointly influencing the development of children's MHS over the course of childhood. Hence, the differential effects of parenting style on population heterogeneity in the joint developmental trajectories of children's internalising and externalising MHS were examined. Method. A community sample of 7507 young children (ages 3, 5 and 9) from the Growing Up in Ireland cohort study was derived for further analyses. Parallel-process linear growth curve and latent growth mixture modelling were deployed. Results. The results indicated that the linear growth model was a good approximation of children's MHS development (CFI = 0.99, RMSEA = 0.03). The growth mixture modelling revealed three classes of joint internalising and externalising MHS trajectories (VLMR = 92.51, p < 0.01; LMR = 682.19, p < 0.01; E = 0.86). The majority of the children (83.49%) belonged to a low-risk class best described by a decreasing trajectory of externalising symptoms and a flat low trajectory of internalising MHS. In total, 10.07% of the children belonged to a high-risk class described by high internalising and externalising MHS trajectories, whereas 6.43% of the children were probable members of a mild-risk class with slightly improving yet still elevated trajectories of MHS. Adjusting for socio-demographics, child and parental health, multinomial logistic regressions indicated that hostile parenting was a risk factor for membership in the high-risk (OR = 1.47, 95% CI 1.18-1.85) and mild-risk (OR = 1.57, 95% CI 1.21-2.04) classes. Consistent (OR = 0.75, 95% CI 0.62-0.90) parenting style was a protective factor only against membership in the mild-risk class. Conclusions. In short, the findings suggest that a non-negligible proportion of the child population is susceptible to being at high risk for developing MHS. Moreover, a smaller proportion of children was improving but still displayed high symptoms of MHS (mild-risk). Furthermore, hostile parenting style is a substantial risk factor for increments in child MHS, whereas consistent parenting can serve as a protective factor in cases of mild-risk. Evidence-based parent training/management programmes may be needed to reduce the risk of developing MHS. [ABSTRACT FROM AUTHOR]

Abstract Aims Multiple studies have connected parenting styles to children's internalising and externalising mental health symptoms (MHS). However, it is not clear how different parenting styles are jointly influencing the development of children's MHS over the course of childhood. Hence, the differential effects of parenting style on population heterogeneity in the joint developmental trajectories of children's internalising and externalising MHS were examined. Method A community sample of 7507 young children (ages 3, 5 and 9) from the Growing Up in Ireland cohort study was derived for further analyses. Parallel-process linear growth curve and latent growth mixture modelling were deployed. Results The results indicated that the linear growth model was a good approximation of children's MHS development (CFI = 0.99, RMSEA = 0.03). The growth mixture modelling revealed three classes of joint internalising and externalising MHS trajectories (VLMR = 92.51, p < 0.01; LMR = 682.19, p < 0.01; E = 0.86). The majority of the children (83.49%) belonged to a low-risk class best described by a decreasing trajectory of externalising symptoms and a flat low trajectory of internalising MHS. In total, 10.07% of the children belonged to a high-risk class described by high internalising and externalising MHS trajectories, whereas 6.43% of the children were probable members of a mild-risk class with slightly improving yet still elevated trajectories of MHS. Adjusting for socio-demographics, child and parental health, multinomial logistic regressions indicated that hostile parenting was a risk factor for membership in the high-risk (OR = 1.47, 95% CI 1.18–1.85) and mild-risk (OR = 1.57, 95% CI 1.21–2.04) classes. Consistent (OR = 0.75, 95% CI 0.62–0.90) parenting style was a protective factor only against membership in the mild-risk class. Conclusions In short, the findings suggest that a non-negligible proportion of the child population is susceptible to being at high risk for developing MHS. Moreover, a smaller proportion of children was improving but still displayed high symptoms of MHS (mild-risk). Furthermore, hostile parenting style is a substantial risk factor for increments in child MHS, whereas consistent parenting can serve as a protective factor in cases of mild-risk. Evidence-based parent training/management programmes may be needed to reduce the risk of developing MHS.

Objective: To investigate the association between ultra-processed food (UPF) consumption and internalising symptoms (IS) among adolescents.Design: It is a cross-sectional study. Paper-pencil survey was completed in classroom with information on UPF consumption, IS and selected covariates. IS were assessed with the Internalizing Symptoms sub-scale from the Social Behaviour Questionnaire (IS-SBQ). UPF was evaluated with a FFQ extracted from the Brazilian National School Health Survey. Crude and adjusted association between UPF and IS was investigated with structural equation models.Setting: São Paulo, SP, Brazil.Participants: A total of 2680 students, Mage = 14·85; (95 % CI 14·81, 14·88).Results: UPF consumption was associated with higher scores in IS in the crude (β = 0·14; P < 0·001) and adjusted (β = 0·12; P < 0·001) models. The higher the consumption of UPF, the higher is the IS score. The following variables were associated with a lower risk of UPF consumption: male sex, public school and having more meals with parents. The change in the magnitude of the standardised score was almost negligible, but the model was significantly improved with the inclusion of covariates.Conclusions: Our results provide evidence about the positive association between UPF consumption and IS among adolescents. The association, despite its low magnitude, remained significant after adjusting for potential confounders. These results are relevant considering the increase in UPF consumption worldwide and in low- and middle-income countries. Also, our study emphasises the importance of a healthy diet with a reduction in UPF consumption among adolescents. [ABSTRACT FROM AUTHOR]

Introduction: Athletes frequently experience anxiety and depression at rates similar to or higher than non-athletes. A balanced diet can alleviate athletes internalizing symptoms. Moreover, diet and sleep are all associated with internalising symptoms. Our study investigates how sleep quality mediates the impact of dietary habits on internalizing symptoms in athletes., Methods: The current cross-sectional study involved 758 Chinese young athletes. The adapted Australian Athletes Diet Index was used to assess dietary patterns, and sleep was measured using the Athletes Sleep Screening Questionnaire. The Generalised Anxiety Disorder 7 scale and the Patient Health Questionnaire 9-item scale were used to assess symptoms of anxiety and depression. Structural Equation Modelling (SEM) analysis was used to examine the mediating role of sleep quality in young athletes. Raw scores of chronotypes, sleep quality, anxiety and depression were calculated for the statistical analysis., Results: No significant indirect effects were found in adolescents. In adult athletes, diet mediated the relationship between chronotype and sleep quality ( β  = -0.028, p   <  0.001). Sleep quality mediated the association between diet and anxiety ( β  = -0.060, p  = 0.001), and depression ( β  = -0.076, p  = 0.001). Additionally, diet and sleep quality mediated the association between chronotypes and anxiety ( β  = -0.028, p  = 0.001), and depression ( β  = -0.028, p  = 0.001)., Conclusion: Sleep quality mediated the relationship between dietary patterns and internalising symptoms in young adult athletes. Additionally, diet and sleep quality mediated the association between chronotypes and internalising symptoms in young adult athletes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Gao and Wang.)

Intelligence quotient (IQ), has been found to relate to the presence of internalising symptoms in autism spectrum disorder (ASD). This meta-analysis sought to clarify the direction of the relationship between IQ and two prevalent internalising symptoms, anxiety and depression, in adolescents with ASD. Secondly, this study aimed to highlight methodological factors contributing to inconsistent findings in existing research. Self-reported anxiety was found to be significantly higher in youth with a lower IQ, while depression was positively associated with IQ. Consequently, parents, schools and clinicians should be cautious of underestimating anxiety in youth with a lower IQ. However, care should also be taken to ensure adolescents with ASD without intellectual disabilities are not overlooked with regards to social and emotional support. [ABSTRACT FROM AUTHOR]

Background: High or increasing trajectories of internalising and externalising symptoms in childhood are mutually re-enforcing and associated with poor emotional and behavioural outcomes in adolescence. This study sought to identify classes of children with similar trajectories of internalising and externalising symptoms after adjusting one domain's symptoms for the other's at the classification stage, and to relate them to emotional and behavioural outcomes in mid-adolescence.Methods: We used growth mixture modelling to classify 16,844 members of the Millennium Cohort Study (baseline N=19,244) into distinct classes based on their trajectories, across ages 3,5,7 and 11 years, of internalising and externalising symptoms adjusted for one another. We examined the predictive ability of these classes for depression, self-harm, trouble with police and drug use among 11,134 children with available data at age 14.Results: We identified four classes of children following distinct trajectories of 'pure' internalising and externalising symptoms. After adjustments for confounding, those with increasing or initially high yet decreasing levels of internalising symptomatology, and those with persistently high or increasing levels of externalising problems were at increased risk of depression in early adolescence. Having initially low yet increasing levels of internalising symptomatology was additionally associated with an increased risk of self-harm and drug use in early adolescence.Limitations: We cannot ascertain whether our longitudinal typology of internalising and externalising symptoms holds for outcomes later in adolescence or adulthood.Conclusions: Interventions aiming to prevent depression, drug use or self-harm in mid-adolescence may be more successful if they target children showing increasing internalising symptoms in the primary school years. [ABSTRACT FROM AUTHOR]

Introduction: There is evidence of high rates of psychopathological disorders such as anxiety or depression in adults with Down syndrome. Additionally, difficulties in executive functions and emotion regulation play an essential role in adaptive functioning of people with Down syndrome. Method: We used different questionnaires with a sample of 42 adults with Down syndrome (aged 18–40 years) to determine if difficulties in executive functions and emotion regulation are related to and can predict internalising symptoms. Results: Positive and significant correlations were found between dysexecutive functioning and emotion dysregulation and internalising symptoms. Multiple linear regression analyses indicated that dysexecutive functioning and emotion dysregulation are both predictors of the existence of internalising symptoms. Conclusions: These findings suggest that intervention in emotion regulation and executive functions must be taken into account in order to positively influence the presence of internalising symptoms. Further research is needed to attend to both capacities comprehensively, especially concerning emotion regulation. [ABSTRACT FROM AUTHOR]

Low emotional clarity has been a target for psychological interventions due to its association with increased internalising symptoms. However, theory suggests that very high emotional clarity may also lead to increased symptoms, particularly in combination with high levels of neuroticism. As an initial empirical test of this hypothesis, the present study examined curvilinear associations of emotional clarity with internalising symptoms (i.e. dysphoria, social anxiety, panic, traumatic intrusions) and a moderating role of neuroticism/negative affect in the association across two student samples and two clinical samples (total N = 920). Evidence of curvilinear associations and moderation varied across samples, with some supporting evidence in three samples. Specifically, neuroticism/negative affect moderated the curvilinear association of emotional clarity with traumatic intrusions in Clinical Sample 2 as well as the linear association between emotional clarity and dysphoria in Student Sample 2 and Clinical Sample 1. Simple slope analyses indicated that high emotional clarity was not consistently associated with lower symptoms. Also, the hypothesised quadratic effects of emotional clarity were found in Student Sample 2 and Clinical Sample 1 for panic, and in Clinical Sample 1 for dysphoria. Implications and limitations of these findings for conceptualisations of emotional clarity and current treatments were discussed. [ABSTRACT FROM AUTHOR]

Background: Developmental coordination disorder (DCD) affects 5%–6% of children. There is growing evidence that DCD is associated with greater levels of internalising symptoms (i.e. depression and anxiety). This is the first systematic review and meta‐analysis to explore the magnitude of this effect, the quality of the evidence and potential moderators. Methods: A systematic search was conducted to identify studies reporting a comparison between individuals with DCD/probable DCD and typically developing (TD) individuals on measures of internalising symptoms. A pooled effect size (Hedges g) was calculated using random‐effects meta‐analysis. Study quality, publication bias and potential moderators of the effect were explored. Results: Twenty studies, including a total of 23 subsamples, met the inclusion criteria, of which 22 subsamples were included in the meta‐analysis (DCD: n = 1123; TD: n = 7346). A significant, moderate effect of DCD on internalising symptoms was found (g = 0.61). This effect remained robust after accounting for publication bias and excluding lower quality studies. The effect was significantly larger in studies utilising a cross‐sectional design (vs. longitudinal), convenience sampling (vs. population screening) and a majority male sample. Conclusions: The findings demonstrate that individuals with DCD experience greater levels of internalising symptoms than their peers. This highlights the importance of routine screening for emotional difficulties in DCD, raising awareness of the condition in mental health services and developing psychosocial interventions that extend beyond a focus on motor impairments. However, there is a need for higher quality, longitudinal studies to better understand the causal relationship between DCD and internalising symptoms. [ABSTRACT FROM AUTHOR]

Psychiatric symptoms in childhood are closely related to neurocognitive deficits. However, it is unclear whether internalising and externalising symptoms are associated with general or distinct cognitive problems. We examined the relation between different types of psychiatric symptoms and neurocognitive functioning in a population-based sample of 1177 school-aged children. Internalising and externalising behaviour was studied both continuously and categorically. For continuous, variable-centred analyses, broadband scores of internalising and externalising symptoms were used. However, these measures are strongly correlated, which may prevent identification of distinct cognitive patterns. To distinguish groups of children with relatively homogeneous symptom patterns, a latent profile analysis of symptoms at age 6 yielded four exclusive groups of children: a class of children with predominantly internalising symptoms, a class with externalising symptoms, a class with co-occurring internalising and externalising symptoms, that resembles the CBCL dysregulation profile and a class with no problems. Five domains of neurocognitive ability were tested: attention/executive functioning, language, memory and learning, sensorimotor functioning, and visuospatial processing. Consistently, these two different modelling approaches demonstrated that children with internalising and externalising symptoms show distinct cognitive profiles. Children with more externalising symptoms performed lower in the attention/executive functioning domain, while children with more internalising symptoms showed impairment in verbal fluency and memory. In the most severely affected class of children with internalising and externalising symptoms, we found specific impairment in the sensorimotor domain. This study illustrates the specific interrelation of internalising and externalising symptoms and cognition in young children. [ABSTRACT FROM AUTHOR]

• Six non-specific treatment factors and five specific treatment factors identified. • One specific and four non-specific treatment factors appear in multiple studies. • More research is required to replicate findings. • TRC should include general components and specified approaches to sub-groups. There is limited evidence on how Therapeutic Residential Care (TRC) achieves treatment goals: TRC remains too much of a "black box". We need to know more about how results are achieved, rather than merely investigating the achieved results. This systematic review aimed to synthesize quantitative literature regarding the associations between non-specific and specific treatment factors and lower or greater internalising and externalising symptoms. Following PRISMA guidelines, a systematic literature search was conducted in July 2021. Of the 2,409 records screened, 40 articles, composed of 38 samples were included. A total of six non-specific treatment factors (individual, family, academic history, symptoms, abuse and trauma history and relationships) and five specific treatment factors (treatment model, therapeutic intervention, placement decision making, environment and staffing) were reported. Only four non–specific treatment factors and one specific treatment factor appeared in multiple studies while all other factors and sub-factors were not replicated. More research is required to replicate and explore possible specific and non-specific treatment factors associated with internalising and externalising symptoms. The reviewed literature suggested that TRC should target a myriad of non-specific and specific treatment factors to increase the likelihood of success and that family involvement may be a particularly crucial component. Future research should focus on longitudinal studies that explore the long-term impact of non-specific and specific treatment factors on youth during placement and beyond. [ABSTRACT FROM AUTHOR]

The family context plays a critical role in the health of the child. This was the first study to examine the usefulness of the General Functioning subscale of the Family Assessment Device (FAD-GF) in assessing family functioning and its relationship to internalising symptoms in school-aged children aged between 9 and 11 years of age. Eight hundred and forty-seven Year 4 and 5 students from 13 schools (607 intervention students, and 240 control students) participated in the Aussie Optimism Positive Thinking Skills Program (AO-PTS) - a universal school-based program targeting internalising symptoms. Students rated how ‘healthy’ they perceived their family to be at pre-test and at 6-month follow-up. Although some aspects of validity and reliability could be improved, results indicated that perceptions of family functioning at pre-test were predictive of internalising symptoms at the 6-month follow-up. The FAD-GF therefore showed promise as a potential measure of family functioning for children as young as nine years old. Regardless of children’s pre-test levels of perceived family functioning, no intervention effects were found on the anxiety and depression scales; this finding suggests that child perceptions of family functioning may act as a general protective factor against internalising symptomology.

Rural communities in the Haut-Uele Province of northern Democratic Republic of Congo live in constant danger of attack and/or abduction by units of the Lord's Resistance Army operating in the region. This pilot study sought to develop and evaluate a community-participative psychosocial intervention involving life skills and relaxation training and Mobile Cinema screenings with this war-affected population living under current threat. 159 war-affected children and young people (aged 7-18) from the villages of Kiliwa and Li-May in north-eastern DR Congo took part in this study. In total, 22% of participants had been abduction previously while 73% had a family member abducted. Symptoms of post-traumatic stress reactions, internalising problems, conduct problems and pro-social behaviour were assessed by blinded interviewers at pre- and post-intervention and at 3-month follow-up. Participants were randomised (with an accompanying caregiver) to 8 sessions of a group-based, community-participative, psychosocial intervention (n = 79) carried out by supervised local, lay facilitators or a wait-list control group (n = 80). Average seminar attendance rates were high: 88% for participants and 84% for caregivers. Drop-out was low: 97% of participants were assessed at post-intervention and 88% at 3 month follow-up. At post-test, participants reported significantly fewer symptoms of post-traumatic stress reactions compared to controls (Cohen's d = 0.40). At 3 month follow up, large improvements in internalising symptoms and moderate improvements in pro-social scores were reported, with caregivers noting a moderate to large decline in conduct problems among the young people. Trial Registration clinicalTrials.gov, Identifier: NCT01542398 . [ABSTRACT FROM AUTHOR]

This study set out to assess the relationship between pubertal timing and emotional and behavioural problems in middle adolescence. The study involved a school based survey of health, health behaviour and behaviour in school as well as questions about emotional and behavioural problems (the School Health Promotion Study). Secondary schools in four regions and 13 towns in Finland participated in the study in 1998. The respondents were 36,549 adolescents aged 14–16. The study included questions on depression, bulimia nervosa, psychosomatic symptoms, anxiety, drinking, substance use, smoking, bullying and truancy. Among girls, both internalising and externalising symptoms were more common the earlier puberty occurred. Among boys, externalising symptoms only were associated with early puberty. It is concluded that early pubertal timing is associated with increased mental health problems. Professionals working with adolescents should consider the mental health needs of early maturing adolescents. [Copyright &y& Elsevier]

• We test if the level and change of internalising/externalising symptoms predict CRP and IL-6 in the first decade of life • The rate of annual change of internalising symptoms was related to both CRP and IL-6. • A 1-unit increase in that rate was related to an increase of 12% and 8%, respectively Elevations in inflammatory marker levels have been shown to precede internalising and externalising problems in the general child population. One study has found the reverse, that elevations in inflammatory marker levels in childhood follow internalising and externalising problems. However, the authors did not explore the role of the course of these problems in childhood or adjust for a number of potential confounders including psychosocial stressors and prenatal and perinatal exposures. To investigate the association in childhood between the growth of internalising and externalising symptoms and levels of inflammatory markers, while accounting for potential confounders. Using data from the Avon Longitudinal Study of Parents and Children, we tested the association between the trajectories of internalising (emotional and social) and externalising (hyperactivity and conduct) problems, at ages 4, 6, 8 and 9 years, and levels of C-reactive protein (CRP) and interleukin 6 (IL-6) at age 9 years. We analysed data (n = 4525) using latent growth curve modelling and linear regression. Children who had increasing levels of internalising symptoms over childhood were more likely to have higher levels of CRP and IL-6 at 9 years of age, even after adjustment for confounders. A one-unit increase in the rate of annual change of internalising symptoms was related to an increase of 12% and 8% in the level of CRP and IL-6, respectively. However, there was no evidence for an association between externalising symptoms and either inflammatory marker. This study is the first step towards identifying a robust pathway, via increases in emotional and social difficulties, to elevated inflammation in healthy children. This association, if causal, suggests that effective interventions for children experiencing chronic emotional and social difficulties could also have physical health benefits. [ABSTRACT FROM AUTHOR]

Mental health of preschool foster care children: How do foster families influence the way children cope with trauma? Abstract. Parents and other significant persons have an important role when preschool children develop or cope with psychological symptoms following traumatic experiences. The underlying mechanisms of the interaction between traumatic experiences and influences of the foster family are still unclear. This study investigates foster parents' stress levels and parenting styles as moderators or mediators in the context of trau- matic experiences. Foster parents of 286 children between three and seven years participated in an online or paper-and-pencil survey. The results suggest a connection between the traumatic experiences of foster children and the stress levels as well as the parenting styles of their foster parents. While verbosity and laxness as parenting styles moderated the impact of traumatic experiences on externalising symptoms, stress levels mediated the impact of traumatic experiences on children's internalising and externalising symptoms. The results underscore the necessity of standardized preparation of and support for foster parents in order to avoid deterioration of psychological symptoms following traumatic events.

Introduction: Comorbidity between problem gambling and internalising disorders (anxiety and depression) has long been recognised. However, it is not clear how these relationships develop, and what factors can foster resilience to both conditions. The current study draws on longitudinal cohort data to investigate: 1) the cross-sectional and longitudinal relationships between problem gambling and internalising symptoms; 2) whether there are common and/or specific social environmental factors protective against both internalising symptoms and problem gambling in young adulthood; and 3) interactive protective factors (i.e., those that moderate the relationship between problem gambling and internalising symptoms)., Methods: A sample of 2248 young adults (55% female) completed a survey in 2010 (T1) and 2012 (T2) which assessed problem gambling (measured via two items based on established measures), internalising symptoms, and social environmental protective factors., Results: A positive cross-sectional relationship between problem gambling and internalising symptoms was found; however, there was no statistically significant longitudinal relationship between the two conditions. Protective factors for internalising symptoms were observed within the domains of the community, family and peer group; however, there were no statistically significant protective factors identified for problem gambling., Conclusions: These findings demonstrate that the social environmental protective factors for adult internalising symptoms assessed in the present study are poor longitudinal predictors of young adult problem gambling. Given the lack of common protective factors, it may be necessary to focus on separate factors to protect against each condition, if we are to address the comorbidity between problem gambling and internalising symptoms., (Copyright © 2015. Published by Elsevier Ltd.)